Opioid Drug Interactions Flashcards Preview

Clinical Pharmacology > Opioid Drug Interactions > Flashcards

Flashcards in Opioid Drug Interactions Deck (12)
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1
Q

Opioid Absorption

A
  • Well absorbed from SQ, IM, transdermal, and mucosal surfaces
  • Most have extensive 1st pass metabolism
  • Low bioavailability overall
2
Q

Absorption interactions

A

-delay gastric emptying & absorption of many orally administered drugs (especially platelet inhibitors)

3
Q

CYP3A4 Substrates

A
  • Oxycodone (major)
  • Hydrocodone (major)
  • fentanyl (major)
  • buprenorphine
  • tramadol (major)

***All of these are contraindicated with Clarithromycin

4
Q

CYP2D6 Substrates (Major)

A
  • Codeine (major)
  • Tramadol (major)
  • Oxycodone (minor)
  • Hydrocodone (minor)
  • Potent CYP2D6 inhibitors will prevent these drugs from being converted
  • Ultra-rapid metabolizers may have issues with OD
5
Q

Opioids with essentially no CYP interaction

A
  • Hydromorphone
  • oxymorphone
  • Morphine

**more predictable in patients with CYP2D6 polymorphisms

6
Q

Mu Receptor

A

-analgesia, euphoria, respiratory depression, physical dependence properties

7
Q

Opioid additive interactions

A
  • Additive analgesia with APAP/NSAIDs –> GOOD!

- Increased sedation with other sedatives/hypnotics –> BAD!

8
Q

All Opioids have a black box warning regarding what class of drugs?

A

Benzos

9
Q

Which drug class is contraindicated with or within 14 days of using an opioid?

A

MAOI

**All products contraindicated

10
Q

What two opioids put patients at risk for serotonin syndrome when combined with other serotonergic drugs?

A
  • Tramadol

- Fentanyl

11
Q

What is a common result of mixing opioids and anticholinergic drugs?

A

Constipation

12
Q

Which two opioids increase the risk of seizures if combined with bupropion, SSRI/SNRI, TCA, or antipsychotics?

A
  • Tramadol

- Tapentadol